Iintravesical instillation of bacillus calmette guerin versus intravesical instillation of hyaluronic acid in the treatment of interstitial cystitis

ABSTRACT

The study included thirty adult female patients with a mean age of [40-50y] with a interstitial cystitis. Patients were divided into two equal groups. First group was treated with intravesical installation of hyaluronic acid 40 my in 50-ml solution weekly repeated for 4 weeks then once monthly for 6 months. The second group was treated with intravesical installation of BCG [Tic strain] 40 my in 50-ml solution weekly repeated for 6 weeks. Evaluation was done according to symptom score. Improvemen occurred in both groups. With hyaluronic acid, maximum response reached by 24 weeks in which positive response occurred in 66.6% [complete response 13.3% and partial response 53.3%]. By the end of 48 weeks positive response decreased to 40% [complete response 6.6% and partial response 33.3%]. No reported complication in this group. With BCG, maximum response reached by 12 weeks in which positive response occurred in 73.3% [complete response 20% and partial response 53.3%]. However by the end of 48-week positive response decreased to 60% [complete response 13.3% and partial response 46.6%]. Microscopic haematuria occurred in 53.3% and symptoms of bladder irritability were increased in 20%, but disappeared spontaneously in 6 weeks. Both intravesical BCG and hyaluronic acid installation are effective in the treatment of interstitial cystitis. With BCG the maximum response started early, maintained for prolonged duration and persisted for the period of follow up of 48 3 weeks in 60%. But with intravesical hyaluronic acid the response persisted for the period of follow up of 48 weeks in 40% only